Don't Forget the Bubbles

MAY 10, 2023

You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. There were 15 doctors and nurses from three paediatric EDs. Hot debriefs It’s clear that hot debriefs are valued by experienced ED staff and help reduce emotional toil. And then head back to the paeds ED.

Emergency Department 91

Emergency Department ED CPR OR 91

Core EM

JANUARY 25, 2024

Background: The immediate post intubation period in the ED is a critical time for continued patient stabilization. The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients. mg/kg over several minutes 0.02 – 0.1

ICU 246

ICU Emergency Department Critical Care ALS 246

ACEP Now

MAY 9, 2024

When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. The post Brazilian Butt Lift Procedure Can Result in Emergency Department Visits appeared first on ACEP Now.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

ED 130

ED E-9-1-1 Emergency Department ALS 130

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. AEM Feb 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. The SGEM has done two previous podcasts on APPs in the ED.

Emergency Department 130

Emergency Department ALS ED EMS 130

EMDocs

JULY 25, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights The challenge of suicide evaluation in the ED “I’ve changed my mind. Medscape, January 08, 2019.

ED 81

ED ALS Emergency Department OR 81

REBEL EM

JUNE 5, 2023

from 2019 to 2021 (from 48,000 to 81,400 annual deaths), which includes prescription opioids (natural and semi-synthetic opioids and methadone), heroin, and synthetic opioids other than methadone including fentanyl (1). Microdosing and standard‐dosing take‐home buprenorphine from the Emergency Department: A feasibility study.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Chen et al.,

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

The Skeptics' Guide to EM

JULY 27, 2019

Date: July 22nd, 2019 Reference: Yadav et al. A Multifaceted Intervention Improves Prescribing for Acute Respiratory Infection for Adults and Children in Emergency Department and Urgent Care Settings. AEM July 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary.

Emergency Department 130

Emergency Department ED ALS 130

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent.

Emergency Department 89

Emergency Department ALS ED OR 89

EMDocs

AUGUST 22, 2024

6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. One cohort study in a public ED found that 84.5%

Emergency Department 81

Emergency Department ALS E-9-1-1 ED 81

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Date: November 21st, 2019 Reference: Daley et al. Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Daley et al.

Emergency Department 130

Emergency Department ALS ED OR 130

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. We don’t want to go backwards!

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ED Emergency Department ALS Paramedic 65

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. emDOCs.net – Emergency Medicine Education. 2022 Jan 6;8(1):42. doi: 10.3390/gels8010042. PMID: 35049577 ; PMCID: PMC8774352 Suzuko S, Peter G, Philipp L.

Emergency Department 258

Emergency Department ALS ED 258

REBEL EM

JANUARY 23, 2023

Moreover, the FDA approved intravenous (IV) cetirizine to treat acute urticaria in 2019. Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 Article: Abella BS et al. Patients were randomized in a 1:1 ratio.

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. Epub 2019 Apr 17. 2019 Jul;42(4):673-685. Epub 2019 Jan 28. Goldfrank’s Toxicologic Emergencies, 11e. McGraw-Hill Education; 2019. The Clinical Presentations of Nitrous Oxide Users in an Emergency Department. 2019 Oct;15(4):299-303.

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Emergency Department ED OR ALS 162

ALiEM

JANUARY 12, 2024

A 42-year old Bengali man with a history of hyperlipidemia presented to the Emergency Department with facial swelling, diffuse rash, renal insufficiency and proteinuria after receiving his COVID-19 vaccine (Moderna) booster dose. He was advised to go to the Emergency Department. Epub 2019 Dec 20. 2019.12.028.

Emergency Department 130

Emergency Department EMS ED 130

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. 2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use.

Emergency Department 98

Emergency Department ALS ED OR 98

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. The PAWPER tape as a tool for rapid weight assessment in a Paediatric Emergency Department: Validation study and comparison with parents’ estimation and Broselow tape. Int J Emerg Med. J Emerg Med.

E-9-1-1 269

E-9-1-1 Emergency Medical Services Life Support ALS 269

The Skeptics' Guide to EM

APRIL 25, 2020

Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. He has been practicing in Emergency Medicine for over 40 years and involved in EMS services for over 30 years.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

FEBRUARY 26, 2022

Case: You are in discussion with your emergency department (ED) manager about the number of patients boarding for hours to days and you are both aware that many of these patients are attending with mental health crises. ED visits in the US for mental health conditions has increased by 44% from 2006 to 2014.

ED 130

ED ALS Emergency Department OR 130

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. How to assess children with complex needs in the ED.

Emergency Department 52

Emergency Department ED OR ALS 52

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

E-9-1-1 152

E-9-1-1 Plasma Emergency Department OR 152

Broome Docs

OCTOBER 6, 2024

PMID: 39025092 Is early CT actually 100% sensitivity for SAH (Of course not) Roberts et al, Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study. Emergency Medicine Journal Published Online First: 12 September 2024. 2019 Nov 5;322(17):1722. 2018.15583.

Critical Care 112

Critical Care ALS Emergency Department EMS 112

ACEP Now

DECEMBER 10, 2023

In the program, Medicare patients who visit a participating emergency department (ED) with specific diagnoses will have their 14-day total cost of care measured across all settings by the state regulatory agency, also known as the Health Services Cost Review Commission (HSCRC). 1 In total, the program includes 535 ED diagnoses.

Emergency Department 52

Emergency Department ED ALS OR 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Kaushal Khambhati is also a fourth-year resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.

EMR 130

EMR Coronary Defibrillator Life Support 130

The Skeptics' Guide to EM

FEBRUARY 16, 2019

Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. Guest Skeptic: Dr. Daniel Theodoro is an Assistant Professor of Emergency Medicine at Washington University School of Medicine in St. Louis and the Emergency Medicine Point of Care Ultrasound Section Chief. AEM January 2019.

ED 130

ED Emergency Department OR 130

The Skeptics' Guide to EM

OCTOBER 19, 2019

Date: October 17th, 2019 Reference: Driver et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation. Date: October 17th, 2019 Reference: Driver et al. The Bougie and First-Pass Success in the Emergency Department.

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department ED OR ALS 135

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion.

Coronary 125

Coronary ACS Emergency Department Defibrillator 125

REBEL EM

FEBRUARY 21, 2024

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Can J Emerg Med 2007; 9(1): 30-2. Ann Emerg Med 1995;26:117-20. Acad Emerg Med; 1998; 5(2): 118-122.PMID: 2019; 36: 401-6.

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E-9-1-1 Emergency Department ALS ED 64

The Skeptics' Guide to EM

DECEMBER 28, 2019

Date: December 16th, 2019 Reference: Moore et al. Annals of EM, JU, and JACR 2019. Guest Skeptics: Dr. Christopher Moore is an Associate Professor of Emergency Medicine a Yale School of Medicine. Date: December 16th, 2019 Reference: Moore et al. Annals of EM , JU, and JACR 2019. NEJM 2014 ).

Emergency Department 100

Emergency Department ALS EMS ED 100

ALiEM

APRIL 12, 2024

Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency department (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). The Cochrane database of systematic reviews, 2019(10), CD002312. Br J Radiol. 2000;73(871):786-790.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

The Skeptics' Guide to EM

JUNE 20, 2020

Case: A 5-week-old full term female presents to the Emergency Department […] The post SGEM#296: She’s Got the Fever but Does She Need an LP, Antibiotics or an Admission? first appeared on The Skeptics Guide to Emergency Medicine. Febrile infants commonly present to the emergency department. JAMA Pediatr.

OR 100

OR Emergency Department ALS ED 100